Reimbursement Request Form - Ohio Attorney General Sexual Assault Forensic Examination (Safe) Program - Ohio

Reimbursement Request Form - Ohio Attorney General Forensic Examination (Safe) Program is a legal document that was released by the Ohio Attorney General - a government authority operating within Ohio.

FAQ

Q: What is the Reimbursement Request Form for the Ohio Attorney General Sexual Assault Forensic Examination (SAFE) Program?
A: The Reimbursement Request Form is a document used by healthcare facilities to seek reimbursement for conducting sexual assault forensic examinations in Ohio.

Q: Who is eligible to use this Reimbursement Request Form?
A: Healthcare facilities that have conducted sexual assault forensic examinations in Ohio under the Ohio Attorney General SAFE Program are eligible to use this form.

Q: What is the purpose of the Ohio Attorney General SAFE Program?
A: The Ohio Attorney General SAFE Program provides funding to support the compassionate and comprehensive care of sexual assault survivors by reimbursing healthcare facilities for the costs associated with conducting sexual assault forensic examinations.

Q: What expenses can be reimbursed through this program?
A: Expenses that can be reimbursed through the Ohio Attorney General SAFE Program include the costs of medical examinations, evidence collection kits, medications, emergency contraception, and other related services.

Q: What supporting documentation is required when submitting a Reimbursement Request Form?
A: When submitting a Reimbursement Request Form, healthcare facilities must include supporting documentation such as a copy of the medical report, itemized bills, and proof of payment.

Q: Is there a deadline for submitting reimbursement requests?
A: Yes, reimbursement requests must be submitted within 60 days of the date of the sexual assault forensic examination.

Q: How long does it take to process a reimbursement request?
A: The processing time for reimbursement requests can vary, but healthcare facilities can typically expect to receive payment within 30 to 60 days.

Q: Are there any limitations on reimbursement through the Ohio Attorney General SAFE Program?
A: Yes, there are limitations on reimbursement through the Ohio Attorney General SAFE Program. For example, reimbursement is not available for services provided to individuals who are not Ohio residents.